BACKGROUND: Sixty percent of all cancer and seventy percent of cancer mortality occurs in people over age 65. As the population ages, there is an emerging need to develop a means for oncologists to characterize the "functional age" of older patients with cancer in order to tailor treatment decisions and stratify outcomes based on factors other than chronological age and to develop interventions to optimize cancer treatment. HYPOTHESIS: A geriatric instrument for older patients with cancer can be formulated to identify factors independent of age that predict cancer treatment morbidity and mortality and result in rationale interventions to optimize oncologic care. SPECIFIC AIMS: 1) To determine the generalized feasibility and psychometric properties of a newly developed geriatric instrument for older patients with cancer;2) To assess the geriatric instrument's ability to predict which older patients are more vulnerable to toxicity from chemotherapy;and 3) To determine the impact of the geriatric instrument on clinical care and overall outcomes through specific interventions. CAREER DEVELOPMENT: Through this work, the candidate will meld her previous training in geriatrics and oncology and develop the skills needed to develop an independent research career in geriatric oncology. Five years of didactic coursework in clinical trial design, biostatistics, and measurement development are planned. The candidate will be mentored by experts in the fields of oncology (Dr. George Bosl, Mentor), geriatrics (Dr. Mark Lachs, Co-Mentor), psychosocial research (Dr. Alice Kornblith, Advisor), and biostatistics (Dr. Katherine Panageas and Dr. Bercedis Peterson, collaborators). Through this career development award, the applicant will acquire the skills necessary to pursue an independent research career in geriatric oncology. Through the support of this grant, the candidate aims to further knowledge about geriatric oncology, and thus enhance the health and independence as well as the quality of life of older Americans with cancer.